Patient satisfaction may not correlate with care quality

Care quality and patient satisfaction do not necessarily correlate, according to a new study published in JAMA Internal Medicine.

Researchers, led by Sosena Kebede, M.D., of Johns Hopkins University's Armstrong Institute for Patient Safety and Quality, interviewed 177 internal medicine patients who had at least two medical conditions, at least two medical procedures and stayed in the hospital at least two days between June 2012 and Feb. 2013. Kebede and her team asked that patients rate their overall satisfaction, and identify their medical diagnoses, their medication instructions, and the tests and procedures they underwent. Researchers then compared these answers to documentation by physicians, according to the study.

Researchers found patients' knowledge of their own care was suboptimal, Kebede told Medical Research in an interview. "Some forms of poor shared understanding could have potentially serious implications for their health and for future care," she said, "such as identifying a prescribed antidepressant as a blood thinner, or mistaking an echocardiogram for a left heart catheterization, or thinking a liver cyst is a liver cancer."

Other misunderstandings might seem minor, such as not understanding the reasons for a procedure or what the results indicate, Kebede said, but such occasions raise questions about whether the patient was able to give informed consent.

Experts must study the subject further, Kebede told Medical Research, because the results raise questions as to how much information patients should have about their inpatient care.

A 2012 study found that admissions and drug expenditures were higher among highly-satisfied patients. In a 2014 follow-up, lead author Joshua J. Fenton, M.D., warned that since patients have little perception of technical care quality, it may not be reflected in their satisfaction ratings. A 2013 study found a similar gap between patient assessments and clinical measures of care quality, FierceHealthcare previously reported.